Individual
CHASE MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2104 GROVEGLEN LN S, LAKELAND, FL 33813-3719
(863) 944-5264
Mailing address
2104 GROVEGLEN LN S, LAKELAND, FL 33813-3719
(863) 944-5264
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA23272
FL
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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